Gastric cancer (GC) is the fifth most common malignancy worldwide, with 968,784 new cases reported in 2022. Since 1975, when stomach cancer was the most common cancer, its incidence has declined in many regions. This decline can be attributed to improved food preservation and recognition of Helicobacter pylori (H. pylori) as a group 1 carcinogen in intestinal-type GC. The aim of this review was to summarize current strategies for primary and secondary prevention of GC, with an emphasis on H. pylori management, dietary factors, novel biomarkers, and screening approaches relevant in Europe. Papers from large databases, namely Web of Science, Scopus, and PubMed/MEDLINE, were selected (reviews, guidelines, and peer-reviewed studies) from about the last 1–5 years. The research was conducted using the keywords gastric cancer, prevention, primary prevention, secondary prevention, and endoscopy guidelines on prevention of gastric cancer. Primary prevention of GC is directed at screening for H. pylori and dietary changes. Secondary prevention is supported by traditional tumor markers, pepsinogen-based serological biopsy, newer blood-based markers, and major technological progress in endoscopy. High-definition endoscopy, magnification, virtual chromoendoscopy, and artificial intelligence have improved the detection of preneoplastic lesions and early cancer, while advanced therapeutic techniques such as endoscopic mucosal resection and endoscopic submucosal dissection permit organ-sparing treatment. Large projects, including GISTAR, EUROHELICAN, TOGAS, and EUCanScreen, are expected to clarify optimal screening strategies. Although GC incidence has declined, it remains a common and significant malignancy. Understanding the facets of primary and secondary prevention of GC will lead to a reduction in the burden of this disease.

Background: This case report addresses the diagnostic challenge of distinguishing intestinal tuberculosis (ITB) from Crohn’s disease, with a focus on the potential role of fecal zonulin as a noninvasive biomarker. Case presentation: A 43-year-old female with a history of deep vein thrombosis, asthma, and previously treated pulmonary tuberculosis presented with fatigue, chronic diarrhea, diffuse abdominal pain, significant weight loss (~ 20 kg), and anorexia. Laboratory findings included a positive fecal occult blood test and markedly elevated fecal calprotectin (3370 µg/g, normal range: < 50 μg/g). Celiac disease serologies were negative. Abdominopelvic tomography showed pathological thickening of the digestive tract wall. Fecal zonulin was normal (10.75 ng/mL, reference range < 107 ng/mL). Upper endoscopy revealed multiple gastric ulcers and an esophageal ulcer suggestive of tuberculosis. Despite clinical and biochemical features mimicking IBD, endoscopic findings and normal fecal zonulin levels prompted suspicion of gastrointestinal TB. The pulmonology department confirmed intestinal tuberculosis and reactivation of the pulmonary tuberculosis after microscopic examination of the patient’s sputum and fecal samples. Antituberculous therapy was initiated with favorable evolution. Conclusion: This case highlights the diagnostic overlap between ITB and Crohn’s disease and underlines the importance of integrating clinical history, imaging, and biomarkers. Fecal zonulin may aid in differentiating ITB from Crohn’s disease by reflecting intestinal permeability patterns, potentially preventing misdiagnosis and inappropriate immunosuppressive treatment. As a biomarker reflecting intestinal barrier integrity, fecal zonulin measurement may have broader implications that warrant further investigation.

Background and Objectives: Intestinal barrier dysfunction is increasingly recognized as a contributor to inflammatory bowel disease (IBD) pathophysiology. Zonulin, a regulator of epithelial tight-junction permeability, has emerged as a potential non-invasive biomarker; however, its clinical relevance remains uncertain. This study evaluated whether fecal zonulin levels reflect clinical disease activity in inflammatory bowel disease and explored their association with ileal involvement in Crohn’s disease (CD). Materials and Methods: Forty-six consecutive IBD patients (26 CD, 20 UC) were prospectively included. Fecal zonulin was measured using a commercially available ELISA. In this study, the term “fecal zonulin” refers to ELISA-detected zonulin-related proteins. Clinical disease activity was assessed using CDAI for CD and the Mayo score for UC. Standard blood and fecal inflammatory markers were obtained, and subgroup analyses were performed according to disease type and location. Results: Fecal zonulin levels were significantly higher in active IBD compared with remission (106.37 vs. 53.80 ng/mL, p = 0.002). Patients with CD had higher zonulin concentrations than those with UC (91.4 vs. 51.0 ng/mL, p = 0.001). Zonulin showed a moderate positive correlation with fecal calprotectin (r = 0.338; p = 0.021). In multivariable analysis, clinical disease activity remained independently associated with zonulin levels, whereas ileal involvement was no longer statistically significant. Conclusions: Fecal zonulin is associated with disease activity in IBD, suggesting that fecal zonulin-related proteins may represent a potential adjunctive marker of epithelial barrier dysfunction and clinical disease activity in IBD. However, these findings should be considered exploratory and require validation in larger, longitudinal multicenter studies using standardized assays and endoscopic correlation.

Background: Inflammatory bowel diseases (IBD), Crohn’s disease and ulcerative colitis, are affecting millions of people around the world with an increasing incidence. Fatigue is an exhausting and highly relevant symptom in patients with inflammatory bowel disease. This study was aimed to investigate the influence of disease activity, paraclinical findings, and level of vitamin B1 on fatigue in patients with IBD. A cross-sectional study including questionnaires was performed on patients with IBD in Gastroenterology Clinic No. 1 in Targu Mures. Additionally, demographic data, laboratory data, IBD history, treatment, and current disease activity were recorded. The blood samples of patients were analyses for level of B1 vitamin. Fatigue severity was assessed using FACIT-F score, a fatigue scale. Results: A total of 41 patients with IBD were enrolled (43.9% with Crohn’s disease and 56.1% with ulcerative colitis). Fatigue was reported by 41.5% of patients, and 21.95% declared to experience severe fatigue. Thiamine level was not associated with the presence of fatigue. Female sex was associated with the presence of fatigue (p = 0.005). Positive significant correlations were demonstrated between FACIT-F score and level of hemoglobin and (p = 0.006, r = 0.58), hematocrit level (p = 0.0031, r = 0.45), albumin (p = 0.01, r = 0.366), and total proteins (p = 0.033, r = 0.330). Conclusion: Fatigue was identified at almost half of patients with IBD. The plasma level of thiamine in IBD patients was normal, regardless of the presence of fatigue. Fatigue was positively correlated with female sex, active disease, level of hemoglobin, and albumin.

Background and aims: Cytomegalovirus (CMV) colitis is a clinically significant complication in patients with inflammatory bowel disease (IBD), particularly in those with severe or steroid-refractory disease, where it may contribute to adverse outcomes. This study aimed to determine the frequency of acute CMV infection and tissue-confirmed CMV colitis among hospitalized IBD patients who underwent CMV evaluation. Methods: We conducted a retrospective study including adult patients with IBD hospitalized between April 1, 2024, and December 31, 2024, at the Emergency Clinical County Hospital of Târgu Mureș, Romania. CMV serology (immunoglobulin G (IgG), immunoglobulin M (IgM)), colonoscopy with biopsy, and immunohistochemistry were performed when clinically indicated. Demographic characteristics, clinical presentation, treatment regimens, laboratory parameters, and histopathologic findings were analyzed for all included patients. Results: 54 IBD patients were evaluated. The mean age was 41 years, and most were male. Crohn's disease was diagnosed in 24 patients (44.44%) and ulcerative colitis in 30 patients (55.56%). Three patients (5.55%) showed evidence of acute CMV infection based on serology. Only one patient (1.85%) was diagnosed with CMV colitis by immunohistochemistry. All patients with evidence of CMV infection had received corticosteroid therapy, although the small number of cases limits interpretation. Conclusions: CMV colitis was uncommon in this cohort of evaluated patients. Diagnosis primarily relied on histopathologic confirmation, with serology serving only as a limited adjunct. CMV infection should be considered in patients with active or steroid-refractory disease. Observations regarding corticosteroid exposure should be interpreted cautiously and considered hypothesis-generating.

Background and Objectives: Antimicrobial resistance (AMR) is a major challenge, particularly in intensive care units, where broad-spectrum therapy is often initiated before microbiological confirmation. Artificial intelligence (AI) may improve AMR prediction, but its clinical value depends on integration with bioengineering-enabled digital microbiology. This narrative review examines how AI, bioengineering platforms and digital microbiology can support AMR prediction, clinical decision support and antimicrobial stewardship across the sample-to-decision pipeline. Materials and Methods: A targeted narrative review was conducted using PubMed/MEDLINE and Google Scholar. Publications from 2020 onward were prioritized, while earlier seminal studies, methodological frameworks and regulatory documents were included when relevant. Evidence was synthesized across AI-based resistance prediction, antimicrobial stewardship, digital microbiology and bioengineering technologies. Results: AI and machine-learning approaches showed promising performance in patient-level resistance prediction, pathogen-level susceptibility prediction and antimicrobial stewardship. For example, model discrimination reached an AUROC of 0.936 for carbapenem-resistant Klebsiella pneumoniae prediction, while model-guided empirical therapy in Enterobacterales bloodstream infections could have increased active beta-lactam therapy from 70% to 79%. However, most evidence remains retrospective and single-centre, with limited external or prospective validation. Conclusions: AI has considerable potential to support AMR prediction and antimicrobial stewardship, but current evidence primarily demonstrates technical feasibility rather than established clinical effectiveness. Broader implementation will require rigorous validation, integration into clinical workflows, continuous monitoring and demonstration of clinical benefit.